NURSING ROLES IN REPRODUCTIVE

AND SEXUAL HEALTH:

MALE AND FEMALE
REPRODUCTIVE SYSTEM
I. DEFINITION OF TERMS

Obstetrics- a branch of medicine that deals with the care

of women during pregnancy, childbirth, and postpartum
period.

Gynecology- study of the female reproductive organs and

diseases affecting it.

Andrology- study of the male reproductive system

Pediatrics- the branch of medical science concerned in

children and their illness.
Neonatology- concerned with the development and
disorders of newborn babies.

Sexual Health- defined as the health of an individual’s

reproductive system and sexual well being during all
stages of their life.

Gonad- the body organ that produces the cells necessary

for reproduction

.
II. REPRODUCTIVE DEVELOPMENT
(INTRAUTERINE DEVELOPMENT)
• Sex is determined at the moment of conception
• A GONAD produces sex cells (ovary & testes); by week 5 in
utero, primitive gonads are formed
• In both sexes, there are 2 undifferentiated ducts, the
mesonephric (WOLFFIAN) & paramesonephric
(MULLERIAN) duct
• Week 7-8 (males)- gonadal tissue differentiates into
primitive testes & begins formation of testosterone
• Testosterone influences the mesonephric(W) duct to
develop into male reproductive organs as the
paramesonephric(M) duct regresses.
II. REPRODUCTIVE DEVELOPMENT
(INTRAUTERINE DEVELOPMENT)
• If testosterone is absent by week 10, gonadal tissue
differentiates into ovaries & paramesonephric duct(M)
develop into female reproductive organs. Oocytes are
formed
• Week 12, external genitals begin to be visible.
• In males, dt testosterone, penile tissue elongates & the
urogenital fold on the ventral surface of the penis closes
to form the urethra.
• In females with no testosterone, urogenital fold remains
open to form the labia minora; what would be formed as
scrotal tissue in the male becomes the labia majora in the
female.
III. PUBERTAL DEVELOPMENT

• PUBERTY – is the stage of life at which secondary sex change

begins;
• Begins at 9 to 12 years old in girls

• Begins at 9 to 14 years old in boys

A. ROLE OF TESTOSTERONE
• Muscular development
• Physical Growth
• Increase in sebaceous gland secretions that cause typical acne
in both boys and girls during adolescence.
III. PUBERTAL DEVELOPMENT
• Initiates adrenarche

• Androgens are produced by the adrenal gland and the testes in

males.

• Androgens are produced by the adrenal gland and the ovaries

in females.

B. ROLES OF ESTROGEN:

• Release is triggered by FSH

• Influences the development of uterus, fallopian tubes, and

vagina; typical fat distribution; hair patterns; breast
development .
III. PUBERTAL DEVELOPMENT
• THELARCHE – beginning of breast development which usually
starts 1 to 2 years before menstruation

• MENARCHE – beginning of menstruation

onset : 9 – 17 years old in females

average: 12.4 years old in females

• In females with no testosterone , urogenital fold remains open

to form the labia minora
III. PUBERTAL DEVELOPMENT

C. SECONDARY SEX CHARACTERISTICS IN FEMALES:

• Growth spurt

• Increase in the transverse diameter of the pelvis

• Breast development

• Growth of pubic hair

• Onset of menstruation

• Growth of axillary hair

• Vaginal secretions
III. PUBERTAL DEVELOPMENT

C. SECONDARY SEX CHARACTERISTICS IN MALES:

• Increase in weight

• Growth of testes

• Growth of face, axillary and pubic hair

• Voice changes

• Penile growth

• Increase in height

• Spermatogenesis – production of sperm

IV. ANATOMY AND PHYSIOLOGY OF THE
MALE REPRODUCTIVE SYSTEM

EXTERNAL STRUCTURES

1. SCROTUM

 The scrotum or scrotal sac is an anatomical male reproductive structure

located at the base of the penis that consists of a suspended dual-chambered
sac of skin and smooth muscle.
• Rugated, skin-covered, muscular, deeply pigmented pouch suspended
from the perineum
• left scrotum is larger & lower due to longer spermatic cord •Cremaster
muscle- responsible for contraction of the scrotum •midline septum-
separates each sac
• each compartment contains a testis, its epididymis, & a part of the
spermatic cord.
IV. ANATOMY AND PHYSIOLOGY OF THE
MALE REPRODUCTIVE SYSTEM

EXTERNAL STRUCTURES

FUNCTIONS OF THE SCROTUM:

• supports the testes

• helps regulate the temperature of sperm

• protects the testes from trauma

IV. ANATOMY AND PHYSIOLOGY OF THE
MALE REPRODUCTIVE SYSTEM

EXTERNAL STRUCTURES

2. TESTES
 The testes, also known as testicles or male gonads, lie behind the
penis in a pouch of skin called the scrotum. The testes move freely
in the scrotum but each testis is attached to the body wall by a thin
cord called the spermatic cord, which passes through a cavity in the
pelvis and into the abdomen.
• 2 ovoid glands, 2 to 3 cm wide, encased by protective white
fibrous capsule
• male sex glands, correspond to the ovary in female
IV. ANATOMY AND PHYSIOLOGY OF THE
MALE REPRODUCTIVE SYSTEM

EXTERNAL STRUCTURES

• composed of lobules, each lobule containing interstitial cells

(LEYDIG'S CELLS) & seminiferous tubules
• 900 coiled seminiferous tubules produce spermatozoa

• Interstitial cells (Leydig's cells) produce testosterone

FUNCTIONS:

• manufacture male sex cells (gametes) or spermatozoa

• produce several steroid hormones primarily testosterone

IV. ANATOMY AND PHYSIOLOGY OF THE
MALE REPRODUCTIVE SYSTEM

EXTERNAL STRUCTURES

3.PENIS

 The penis is the male sex organ, reaching its full size during puberty.
In addition to its sexual function, the penis acts as a conduit for urine
to leave the body.

• 3 cylindrical masses of erectile tissue in the penis shaft:

 2 CORPUS CAVERNOSA

 1 CORPUS SPONGIOSUM
IV. ANATOMY AND PHYSIOLOGY OF THE
MALE REPRODUCTIVE SYSTEM

EXTERNAL STRUCTURES
• Penile artery supplies blood to the penis

• Erection is innervated by the Peripheral Nervous System

• GLANS - bulging, sensitive ridge of tissue at the distal end of the

penis; similar in function to the clitoris

• PREPUCE/foreskin - retractable casing of skin, protects the glans

• PHIMOSIS - condition in which the prepuce is too tight that it

interferes with the flow of urine
IV. ANATOMY AND PHYSIOLOGY OF THE
MALE REPRODUCTIVE SYSTEM

INTERNAL STRUCTURES

1. EPIDIDYMIS
 The epididymis is a tortuously coiled structure topping the testis, and
it receives immature sperm from the testis and stores it for several
days. When ejaculation occurs, sperm is forcefully expelled from the
tail of the epididymis into the deferent duct.
• a tightly coiled tube responsible for conducting sperm from the
tubule to the vas deferens.
• It is the storage of immature sperm, and a part of the alkaline
fluid (semen, or seminal fluid that contains a basic sugar and
protein) that will surround sperm at maturity is produced by the
cells lining the epididymis.
IV. ANATOMY AND PHYSIOLOGY OF THE
MALE REPRODUCTIVE SYSTEM

INTERNAL STRUCTURES

• Sperm are immobile and incapable of fertilization as they pass

through or are stored at the epididymis level.
• It takes at least 12 to 20 days for them to travel the length of
the tube, and a total of 65 to 75 days for them to reach full
maturity.
• Sperm is capable of surviving for 72 hours inside the woman's
body.
ASPERMIA = absence of sperm
OLIGOSPERMIA = fewer than 20 million sperm per milliliter
IV. ANATOMY AND PHYSIOLOGY OF THE
MALE REPRODUCTIVE SYSTEM

INTERNAL STRUCTURES

2.VAS DEFERENS/DUCTUS DEFERENS

 The ductus deferens, or vas deferens, is a fibromuscular tube that is
continuation of the epididymis and is an excretory duct of the testis.
Each ductus is 30-45 cm in length and serves to transport sperms
cells from the respective epididymis to the ipsilateral ejaculatory
duct.
• is an additional hollow tube surrounded by arteries and
protected by a thick fibrous coating, which altogether, are
referred to as the spermatic cord.
IV. ANATOMY AND PHYSIOLOGY OF THE
MALE REPRODUCTIVE SYSTEM

INTERNAL STRUCTURES

• It carries sperm from the epididymis through the

inguinal canal into the abdominal cavity, where it ends at
the seminal vesicles and the ejaculatory ducts below the
bladder.
• Sperm completely matures as they pass through the vas
deferens. They are still not mobile at this point.
• This is the site severed during vasectomy to prevent
passage of sperm, a popular means of male birth control.
IV. ANATOMY AND PHYSIOLOGY OF THE
MALE REPRODUCTIVE SYSTEM

INTERNAL STRUCTURES

3. PROSTATE GLAND
 The prostate gland is located just below the bladder in men and
surrounds the top portion of the tube that drains urine from the
bladder (urethra). The prostate's primary function is to produce the
fluid that nourishes and transports sperm (seminal fluid). -is a
chestnut-size gland that lies just below the bladder and allows the
urethra to pass through the center of it, like the hole in a doughnut.

FUNCTION:
• to secrete a thin, alkaline fluid, which, when added to the secretion
from the seminal vesicles, further protects sperm by increasing the
naturally low pH level of the urethra.
IV. ANATOMY AND PHYSIOLOGY OF THE
MALE REPRODUCTIVE SYSTEM

INTERNAL STRUCTURES

4. BULBOURETHRAL GLAND
 The bulbourethral gland or Cowper's gland, which is homologous to
the Bartholin's gland in females, produces a pre-ejaculate that
cleanses and lubricates the urethra prior to the arrival of the semen.
• or Cowper's glands lie beside the prostate gland and empty by
short ducts into the urethra. They supply one more source of
alkaline fluid to help ensure the safe passage of spermatozoa.
• SEMEN is derived from the prostate gland (60%), the seminal
vesicles (30%), the epididymis (5%), and the bulbourethral
glands (5%).
IV. ANATOMY AND PHYSIOLOGY OF THE
MALE REPRODUCTIVE SYSTEM

INTERNAL STRUCTURES

5. URETHRA
 The urethra is a thin, fibromuscular tube that begins at the
lower opening of the bladder and extends through the pelvic
and urogenital diaphragms to the outside of the body, called
the external urethral orifice. The urethra also connects the to
the ductus deferens in males, for the ejaculation of sperm.
• is a hollow tube leading from the base of the bladder,
which, after passing through the prostate gland, continues
to the outside through the shaftand glans of the penis.
 ANATOMY AND PHYSIOLOGY OF
FEMALE REPRODUCTIVE SYSTEM
 EXTERNAL STRUCTURES
• Mons veneris/ Mons Pubis- a pad of adipose tissue located
over the symphisis pubis covered by a triangle of coarse curl
hair, the purpose is to protect the junction of the pubic bone
from trauma

• Labia minora- also called the small lips. It is the two hairless
balls of connective tissue just posterior to the Mon’s veneris.

• Labia majora- also called the large lips. It is the two folds
tissue covered by loose connective tissue and epithelium that
serves the protection of external genitilia and vulvar
structures
• Vestibule- flattened smooth almond-shaped that is found
within the labia. It contains openings to the urethra, vagina,
skene’s glands and Bartholin’s glands.

• Glans Clitoris- a small rounded organ of erectile tissue at the

forward of the junction of the labia minora. It is the center of
sexual arousal and orgasm of woman.

• Skene’s glands/ Paraurethral glands- located on each side of

the urinary meatus, they produce alkaline mucus for
lubrication and protection
• Bartholin’s glands/ Paravaginal glands- it is located on each
side of the vaginal opening, secretes an alkaline substance to
lubricate the vaginal orifice and neutralize the acidity of the
vagina

• Perineal Muscle/ Perinial Body- located posterior to the

fourchette.

• Hymen- a tough but elastic semicircle of tissue that covers the

opening of vagina during childhood.

-Imperforate hymen
 INTERNAL STRUCTURES
• Ovaries- approximately 3cm long by 2 cm in diameter and 1.5 cm
thick/ size and shape of almonds. Its function is to produce, mature,
and discharge egg cells.

3 Principal Divisions/ Layers

 Tunica Albuginea

 Cortex

 Medulla

• Fallopian Tubes- approximately 8-10 cm long in a mature woman,

may arise from each upper corner of the uterine body and extend
outward and backward until each open at distal end.
4 S eg ments of Fallopi an Tu be

1. Intersti ti al

2. Isthmus

3. Ampu lla

4. Infu ndibul lum

• Uteru s- hollow mu scu lar, pear-sh aped organ located in th e lower pelvis ,
posteri or to the bladder an d an terior to th e rectum.

3 Divis ion of th e Uteru s

1. Body of th e Uterus

2. Isthmus

3. Cerv ix
• Vagina- a hollow membranous canal located posterior to the
bladder and anterior to the rectum
UTERINE LIGAMENTS

CARDINAL TRANSVERSE-CERVICAL/ MACKENRODT LIGAMENTS

• lower portion of the broad ligaments -damage to this ligament results

UTERINE PROLAPSE BROAD/PERITONEAL LIGAMENTS

• originates from the sides of the corpus & extends tot he lateral pelvic wallS

ROUND LIGAMENT
• connects the uterus to the labia majora and gives stability to the uterus

UTEROSACRAL LIGAMENT
• connects uterus to the sacrum
UTERINE LIGAMENTS

ANTERIOR LIGAMENT
• provides support to the uterus in connection with the bladder.
• Overstretching will lead to herniation of the bladder to the vagina, a
condition called CYSTOCELE

POSTERIOR LIGAMENT
• It forms the cul-de-sac or pouch of Douglas. -Damage will lead to
herniation of the rectum to the vagina, a condition called
RECTOCELE
UTERINE LIGAMENTS
UTERINE DEVIATION
BICORNUATE UTERUS – horns at the junction of the fallopian
tubes
SEPTUM – which divides the uterus
DOUBLE UTERUS
RETROVERSION – fundus in tipped backward
ANTEVERSION – fundus is tipped forward
ANTEFLEXION – body is bent sharply forward at the junction of
the cervix
RETROFLEXION – body is bent sharply back just before the cervix.
UTERINE DEVIATION

FORNICES
• Recesses at the cervical end of the vagina: posterior, anterior and
lateral

POSTERIOR FORNIX
• Site were semen pools after intercourse
• It is lined with stratified squamous epithelium similar to the cervix
• Mucus secretions contain glycogen broken down by DODERLEIN’S
BACILLUS forming lactic acid making the pH 4 to 5 which is acidic;
thus, preventing infections.
UTERINE DEVIATION
• Low E (menopause, child birth and location) causes dryness and
thinnest of the vaginal walls smoothing of the ragae

BULBOCAVERNOSUS MUSCLE
• Acts as a voluntary sphincter; kegel’s exercise strengthens this muscle
ACCESSORY ORGANS

1. MAMMARY GLANDS
• Located anterior to the pectoralis major muscle, between the
sternum & the midaxillary line (between 2 n d & 6 t h ribs), with an
extension called the TAIL OF SPENCE and extends well into the
axilla.

COMPOSITION:
 Divided into 15 to 20 lobes divided into lobules

LOBULES – cluster of ACINAR CELLS/ACINI

LACTIFEROUS OR MILK DUCTS

LACTIFEROUS SINUSES OR AMPULLA

ACCESSORY ORGANS

NIPPLES – composed of smooth muscles capable of erection on

manual or sucking stimulation

AREOLA – appears rough due to sebaceous glands called

MONTGOMERY’S TUBERCLES

- stimulation leads the APG to secrete OXYTOCIN (letdown

reflex or milk ejection reflex)

- after menses, regression occurs & H2O is lost and reaches

minimal alteration levels 5 to 7 days after menses (best
time for breast self-examination
ACCESSORY ORGANS
HORMONES THAT INFLUENCE THE MAMMARY GLANDS

ESTROGEN – development of the ductile structure of the

breast
PROGESTERONE – development of the acinar structures of
the breast
HUMAN PLACENTAL LACTOGEN (HPL) – breast development
during pregancy
OXYTOCIN – let-down reflex or milk ejection reflex
PROLACTIN – directly stimulates milk production
ACCESSORY ORGANS
2. PELVIS
A. FUNCTION
• Support & protect the reproductive & other pelvic organs
• Accomodation of the growing fetus
• Anchorage of the pelvic support structures

B. COMPOSITION
• Anterior & lateral portion made up of 2 innominate hip
bones divided into 3 parts (ilium, ischium and pubis)
• Posterior portion: sacrum, coccyx
ACCESSORY ORGANS

2 DIVISION OF THE PELVIS

1. FALSE PELVIS – upper half which supports the uterus

during the late months of pregnancy & aids in directing
the fetus into the true pelvis for birth
2. TRUE PELVIS – lower half of the pelvis; long, bony, curved
canal divided into 3 parts:
 Inlet
 Pelvic cavity
 Outlet
ACCESSORY ORGANS
ACCESSORY ORGANS
LINEA TERMINALIS OR BRIM – imaginary line consists of the
pubic crest, pectineal line (pecten pubis), the arcuate line. It is
the pelvic brim, which is the edge of the pelvic inlet.